If your child needs a PICC (peripherally inserted central catheter) line, you may have many questions and concerns – and maybe even fears.
Life with a PICC line can be challenging, but with proper knowledge and care you can ensure your child’s well-being and comfort during this time.
What is a PICC?
A PICC is a special tube that goes into a large vein, usually in the arm, to deliver important medications and fluids to your child’s body. It can be used to give intravenous (IV) medications, blood transfusions, fluids, nourishment – and sometimes even draw blood samples.
“Many families find the PICC helps make their child’s treatment a little easier as it helps avoid a lot of needle sticks during treatment,” said Wendy Pauker, associate director of child life with Banner Children’s.
The actual tube can be up to 24 inches long and threads up your child’s arm (or thigh in infants) until it reaches the large vein in their heart. A PICC usually stays in for about a month but can be left longer if needed.
Caring for your child’s PICC
Not knowing what is safe to do with a PICC can feel scary. Can your child run and play like they used to? Can they go to school? The good news is that just because your child has a PICC doesn’t mean they need to slow down.
“As long as you take the steps necessary to prevent infection, your child will be able to move through their life much like before they had a PICC placed,” Pauker said.
Here are some tips to help make life with a PICC much more manageable.
Wash your hands
“The best tip for everyone is good hand hygiene,” Pauker said. “This helps keep your child from getting an infection.”
Use good hand and body hygiene. Don’t touch the catheter or dressing (bandage) unless necessary.
Always clean your hands well with soap and water or an alcohol-based hand sanitizer before and after having contact with any part of the PICC. Wash your fingertips, under your nails, the backs of your hands, around your wrists and between your fingers. Dry your hands with a clean towel.
Follow instructions from your child’s care team regarding the proper care of the PICC and bandage. Call with any questions or concerns.
Keep the PICC and bandage dry
Do your best to keep the PICC and dressing protected so that it stays dry and clean.
Avoid swimming, using a hot tub or doing other things that could get the PICC wet. Avoid using creams, lotions and powders near the catheter as well.
Your child’s care team will teach you how to cover the PICC to keep it dry when your child bathes. You can use plastic wrap or purchase a waterproof shower protector.
If your child’s PICC gets wet, the dressing should be changed immediately.
Secure the PICC to your child’s body
Although the PICC is secure, it is not attached to anything inside your child’s body. Help prevent it from accidentally being pulled out, damaged or broken by keeping the catheter taped to your child’s arm.
Keep the catheter away from sharp objects and away from pets. Do not let your child or other children touch or play with the PICC.
To stay comfortable consider sizing up in clothing
Most children will not have to change their typical clothing, but it is OK to size up if it makes your child more comfortable.
PICCs are usually placed in the arm for children (or the leg for very young babies). Avoid tight or restrictive clothing around the PICC to reduce the risk of pulling or tugging on the catheter.
It’s important to also be careful when dressing and undressing to avoid snagging the line.
Avoid contact sports
Having a PICC shouldn’t prevent your child from participating in everyday activities like school, play and mild exercise. However, they should avoid playing sports that might result in a hit to the PICC or cause the catheter to be pulled out, such as football, soccer, hockey or basketball.
It is also best for your child to avoid playing in sand and dirt (such as sandboxes and beaches) as this can increase the risk of infection.
Prepare for travel
If you will be traveling (especially by plane), your child is allowed a medical carry-on. Ask your child’s provider for a list of any supplies you will need to travel comfortably, as well as documentation you may need to bring.
[Check out these additional tips if you’ll be traveling during your child’s treatment.]
Coordinate with your child’s school
Anyone who cares for your child should know your child has a PICC, how to clamp it and what to do in an emergency. This includes caregivers, teachers and the school nurse.
If your child receives regular treatments, the PICC will be flushed every time they get medications. They will also need their bandage changed. Check with your school’s nurse to make sure they know what must be done.
Schools must also follow any physical activity restrictions or special needs your child may have due to the PICC, so it is important to tell them what may be temporarily unsafe for your child.
Classmates may be naturally curious about your child’s PICC. You can help by preparing your child with what they can say to their classmates about their PICC, especially the importance of being gentle with your child so they stay safe. Your child’s provider can also help with these talking points.
Watch for signs of problems
Contact your child’s health care team immediately for any line breakage, leaking or clogging. They can help you with any next steps regarding care and treatment.
If the PICC is not cared for properly, your child may have problems such as infections, blockages, phlebitis (inflammation of a vein), thrombosis (blood clots) and hemorrhage (bleeding). Go to the nearest emergency department immediately if your child experiences any of the following:
- Shortness of breath or difficulty breathing
- Pain or swelling in the arm, chest or face
- Redness, warmth or a lump at the insertion site
- A racing or irregular heartbeat
- Leakage or drainage at the PICC site
- Bleeding that does not stop with pressure
Caring for a child with a PICC may feel overwhelming at first, but with a few easy safety measures you can ensure a smooth and safe experience for your little one.
Always follow the advice of your child’s health care team, and don’t hesitate to reach out to them if you have any concerns.
With your love and support, your child will get through this challenging time with courage and strength.